Combination of growth factors, cytokines, antibacterial/antiviral factors, stem cell stimulating factors, complement proteins c3a/c4a, immunoglobulins and chemotactic factors

ABSTRACT

The present invention refers to a combination of growth factors, cytokines, antibacterial/antiviral factors, stem cell stimulating factors, complement proteins C3a/C4a, immunoglobulins and chemotactic factors. The invention also relates to a process for the preparation of said combination from serum, placenta or colostrum and to composition containing said combination for use in the treatment of conditions requiring tissue repair and regeneration and for the substitution of stem cell therapies.

The present invention refers to a combination of growth factors,cytokines, antibacterial/antiviral factors, stem cell stimulatingfactors, complement proteins C3a/C4a, immunoglobulins and chemotacticfactors. The invention also relates to a process for the preparation ofsaid combination from serum, placenta or colostrum and to compositioncontaining said combination for use in the treatment of conditionsrequiring tissue repair and regeneration and for the substitution ofstem cell therapies.

BACKGROUND OF THE INVENTION

According to the current scientific literature, the therapeutic actionof stem cells may be due to two mechanisms: differentiation of stemcells into resident cells and release of regenerative trophic factors bystem cells. The respective contributions of these two mechanisms remainto be clarified, although it has been suggested that stem cells do notdevelop into mature cells of the injured tissue, but they rather conveyvital factors to this tissue, which can then return to proliferate anddifferentiate, regenerating itself (A I Caplan and J E Denni,Mesenchymal Stem Cells as Trophic Mediators. Bioch J. Cell 98:1076-1084,2006).

Stem cell therapy has many problems related not only to the costs andtechnical and practical complications but also ethical and religiousscruples.

Stem cell therapy is feasible only by injection or, in some cases,topically, and not orally The supernatant of cultured stem cellscontains growth factors, cytokines, chemotactic factors etc., which arebelieved to be responsible for the beneficial effect of stem celltherapy on tissue growth and/or repair.

The use of the vital factors isolable from the supernatant of stem cellshas, however, not only the same ethical problems of the use of the stemcells themselves but also very high costs.

It is known that some mammalian tissues and biological fluids, namelyserum, placenta and colostrum, contain cytokines, growth factors,chemotactic factors, and other components usually found also in thesupernatant of stem cell cultures.

Several therapeutic applications have been disclosed in the past forpure colostrum or of extracts or fractions thereof as well as forplacenta extracts. For instance, a review of clinical uses of colostrumis reported in Alternative Medicine Review 8(4), 2003, page 378 and inInt. J. Clin. Pharmacol and Therap., 46(5), 2008, 211-225 and inInternational Dairy Journal, 16, 2006, 1415-1420.

Therapeutic uses of colostrum or fractions thereof are also reported inEP 743060, WO 98/51316, WO 94/16675, WO 98/36759, WO 95/00155, WO2007/000648, FR 2487676, WO 98/14473, WO 99/64022, WO 2008/103023 and inWO 2006/029494. The latter discloses the extraction of growth anddifferentiating factors from colostrum but the process disclosednecessarily involves the loss of important components (e.g. cytokines,stem cell stimulating factors, chemiotactic factors andantibacterial/antiviral factors) of pure colostrum. None of the priorart documents discloses compositions derived from easily availablemammalian sources containing most of if not all components of stem cellcultures supernatant, as a substitute for stem cell therapy.

DESCRIPTION OF THE INVENTION

It has been found that a combination of growth factors, cytokines,antibacterial/antiviral factors, stem cell stimulating factors,complement proteins C3a/C4a, immunoglobulins and chemotactic factors isparticularly effective in the treatment of a number of pathologiesthanks to their multifunctional activities on different biologicaltargets.

The combination of the invention is characterized by a content of:

Cytokines: from about 50 to about 300 pg/mg, preferably from 47.81 to264.56;

Growth factors: from about 650 to about 1900 pg/mg, preferably from670.80 to 1869.40;

Chemotactic factors: from about 2 to 20 pg/mg;

Stem cell stimulating factors: from about 100 to 1200 pg/mg, preferablyfrom 136 to 1120;

Antibacterial/antiviral factors: from about 30 to 80 μg/mg, preferablyfrom 21.30 to 71.50;

Complement C3a/C4a proteins: from about 1 to 5 pg/mg, preferably from1.10 to 2.70;

Immunoglobulins: from about 0.3 to 0.9 mg/mg, preferably from 0.35 to0.85.

The cytokines present in the combination of the invention, hereinafterreferred to as PMF Ab, are reported in Table 1:

TABLE 1 Cytokines in PMF Ab (pg/mg) Val min Val max IL-1° 0.80 2.90IL-1b 0.02 0.09 IL-2 0.75 5.00 IL-4 0.04 0.17 IL-6 0.10 1.20 IL-8 0.502.50 IL-9 0.50 3.60 IL-10 0.50 2.80 IL-12 0.50 2.00 IL-15 1.10 4.30IL-17 15.00 150.00 INF gamma 3.00 30.00 TNFα 15.00 30.00 IL-1 Ra 10.0030.00 Total 47.81 264.56

The growth factors present in the combination of the invention arereported in Table 2:

TABLE 2 Growth factors in PMF Ab (pg/mg) Val min Val max TGF-β1 150.00300.00 IGF-1 300.00 800.00 NGF 1.00 10.00 PDGF 5.00 100.00 EGF 4.80 9.40BMP2 15.00 50.00 b.FGF 100.00 200.00 FGF-2 5.00 20.00 HGF 40.00 80.00VEGF 50.00 300.00 Total 670.80 1869.40

The stem cell stimulating factors present in the combination of theinvention are reported in Table 3:

TABLE 3 Stem cell stimulating factors in PMF Ab (pg/mg) Val min Val maxG-CSF 10.00   20.00 GM-CSF 100.00  1000.00 LIF 15.00   50.00 SCF 1.00  10.00 SDF-1 10.00   40.00 Total 136.00 1.120.00

The chemotactic factors present in the combination of the invention arereported in Table 4:

TABLE 4 Chemotactic factors in PMF Ab (pg/mg) Val min Val max EOTAXIN1.00 15.00 MCP-1 1.00 5.00 total 2.00 20.00

The antibacterial/antiviral factors present in the combination of theinvention are reported in Table 5

TABLE 5 Antibacterials/Antivirals in PMF Ab (microgram/mg) Transferrin0.50 1.00 Lactoferrin 0.80 2.50 Lysozyme 10.00 40.00 Lactoperoxydase10.00 30.00 total 21.30 73.5

The complement C3a C4a proteins present in the combination of theinvention are reported in Table 6.

TABLE 6 Complement proteins in PMF Ab Val min Val max C3A 0.20 0.70 C4A0.90 2.00 Total 1.10 2.70

The immunoglobulins present in the combination of the invention arereported in Table 7.

TABLE 7 Immunoglobulins in PMF Ab (mg/mg) Val min Val max IgG 0.20 0.50IgA 0.10 0.20 IgM 0.05 0.15 Total 0.35 0.85

The data reported in Tables 1-7 were obtained by commercially availablesandwich ELISA methods specific for bovine molecules and flexibleBio-Plex® system (Bio-Rad Lab., Hercules, Calif., USA). The term “about”means a variation of ±10%, preferably ±5% of the given value.

The main physiological roles of the components of the combination arereported below.

Complement Proteins C3/C4:

The complement consists of circulating proteins able to interact withthe biological membranes and with specific receptors situated on thesurface of various cell types, which induce inflammatory reactions thathelp combat infection.

Growth Factors

TGF-β1—TRANSFORMING GROWTH FACTOR: stimulates the production of Class Aimmunoglobulins, which are responsible for immune defences in themucosa. Modulates cell proliferation and stimulates the deposit ofextracellular matrix.

EGF—EPIDERMAL GROWTH FACTOR: regulates the development of the mucosa.Promotes the formation of epithelial cells.

IGF 1—INSULIN-LIKE GROWTH FACTOR: modulates cell proliferation, adhesionand migration and induces maturity of the mucosa.

VEGF—VASCULAR ENDOTHELIAL GROWTH FACTOR: stimulates blood vesselproduction. Presents mitogenic activity and activation of vascularpermeability.

FGF-b—FIBROBLAST GROWTH FACTOR BASIC: stimulates proliferation of cellsof mesenchymal origin such as fibroblasts, endothelial cells, astrocytesand keratinocytes. It also acts as a chemotactic factor.

GH—GROWTH HORMONE: general growth factor of all tissues.

GHRF—GROWTH HORMONE RELEASING FACTOR: stimulates the release of GH.required for normal postnatal growth, bone growth, regulatory effects onprotein, carbohydrate, and lipid metabolism.

NGF—NERVE GROWTH FACTOR: stimulates activity and regulates growth anddifferentiation of the sympathetic system.

PDGF-PLATELET DERIVED GROWTH FACTOR: growth/differentiation of cells ofmesodermal origin

BMP-2—BONE MORPHOGENETIC PROTEIN 2: Development of bone and cartilage,cardiac cell differentiation.

Chemotactic Factors

EOTAXIN: binds to the chemokine receptors to recruit eosinophils toinflamed tissues.

MCP-1 Monocyte chemotactic factor-1: promotes aggregation of monocytesto inflamed tissues.

Cytokines

IL-1Ra inhibits the activities of interleukin 1 alpha and interleukin1-beta, modulating a variety of IL 1 related immune and inflammatoryresponses.

IL-2 induces proliferation of T lymphocytes.

IL-4 possesses anti-inflammatory activity.

IL-6 stimulates innate and adaptive immunity.

IL-9 is a regulator of haemopoietic cells, stimulates cell proliferationand prevents apoptosis.

IL-17 regulates the activities of NF-KB and boosts nitric oxide (NO)production.

IL-10 has pleiotropic effects in immunoregulation and inflammation.Improves B cell survival, and therefore antibody production. Studiesconducted on knock-out mice demonstrate that this protein is essentialin immunoregulation of the mucosa. IL-12 stimulates T and natural killercells.

IL-15 regulates T and natural killer cell activation and proliferation.

Interferon-gamma has known antiviral, antitumoral and immunoregulatoryactivities. It is a powerful macrophage activator and activatescell-mediated activity against bacteria and viruses.

TNF-α—Tumour necrosis factor stimulates the migration of neutrophils andmonocytes to the site of infection.

Stem Cell Stimulating Factors

GM-CSF—granulocyte colony stimulating factor: is involved in thestimulation and peripheral dismission of immune progenitors from thebone marrow.

LIF—Leukemia inhibitory factor: pleiotropic cytokine with roles inseveral different systems, involved for instance in the induction ofhematopoietic differentiation in normal and myeloid leukemia cells,induction of neuronal cell differentiation, regulator of mesenchymal toepithelial conversion during kidney development.

SCF—Stem cell factor: acts in utero in germ cell and neural celldevelopment and hematopoiesis.

SDF-1—stromal derived factor-1: acts as a chemotactic factor ofstem-progenitor cells expressing the CXCR4 ligand.

Antibacterials

Transferrin: delivers iron to red blood cells and prevents bacteria andviruses binding to iron.

Lactoferrin: deprives bacteria and viruses of iron required for theirgrowth.

Lysozyme: has antibacterial effects in view of its enzymatic activityand as a consequence of its cationic and hydrophobic properties.

Lactoperoxydase: inhibits bacterial metabolism by oxidation of essentialprotein SH groups.

The combination of the invention may be prepared by extraction ofcolostrum, serum from pre-partum mammals or placenta according to themethods detailed below.

The serum has the highest peak of the factors in the last days beforethe birth, colostrum in the first hours after birth and no later thanthe 6th hour.

After 12 hours of delivery, the factors in colostrum decreasesignificantly and at 24 h many of them are no longer detectable.

These factors are genetically highly conserved in different species andtherefore it is possible to use factors isolated from other mammalianspecies such as cattle, horses, camels, marine mammals, etc.

The factors are controlled with ELISA assays, specific for the species,even if the interspecies cross-reaction is very high because the factorsare phylogenetically very conserved and are therefore qualitativelymeasurable also with ELISA used for different species (eg human-bovineand vice versa).

It is not necessary to add antibacterial preservatives to colostrum,serum or placenta since the extraction procedure allows the preparationof a product having a very low bacterial count (<40 c.f.u), much lowerthan the value admitted for the considered uses (<1000 c.f.u.). Thepresence of pyrogens for oral or topical administration is irrelevant.

Extraction from Mammalian Serum

The serum of mammals pregnant females has the highest peak of thecomponents of the combination of the invention in the last days beforethe delivery or parturition, usually in the last 5-15 days.

A typical procedure for the preparation of the combination of theinvention is described.

1 liter of blood is drawn in 4 days for a total of 4 samples to preventdamage to the animal, preferably bovine or equine.

Serum is separated from the blood at room temperature for 24 h and thencentrifuged to squeeze the clot.

Serum is recovered (approximately 30/40% of the total volume) and isthen subjected to the following steps.

Ultrafiltration 300,000 Da:

The serum sample (frozen at −20° C.) obtained by coagulation andcentrifugation from mammalian blood is thawed at room temperature anddiluted with 2 volumes of demineralized water. The resulting solution isultrafiltered through a Millipore Biomax Pellicon 300,000 Da planetangential flow membrane in Polyethersulfone at Pi of 0.5 to 1 bar, in acold room at 4° C.

The retentate and a fraction corresponding to about 1:10 of the permeateare transferred into a 1000 Da dialysis tube from Spectrum SpectraPor inregenerated cellulose and dialyzed against demineralized water.

Ultrafiltration 5,000 Da:

The remaining permeate is ultrafiltered through a 5000 Da membrane. Thepermeate from the 300,000 Da ultrafiltration is concentrated on a 5000Da plane tangential flow membrane Millipore Biomax Pellicon inPolyethersulfone at Pi from 0.5 to 1 bar, cold room at 4° C.

The retentate is transferred to a 1,000 Da dialysis tube in regeneratedcellulose from Spectrum SpectraPor and dialyzed against demineralizedwater. The product is then immediately lyophilized.

Extraction from Placenta

Bovine, equine or suine placenta is preferably used.

Homogenization:

The placenta (frozen at −20° C.) is thawed at room temperature, cut intosmall pieces, washed with copious amounts of cold (4° C.) physiologicalsaline (NaCl 0.9%) and homogenized using a Siramm cutter in a lysisbuffer having the following composition: Tris/HCl 50 mM, EDTA 25 mM,triton X-100 0.001% at pH 7.4. NaCl to a concentration of 0.9% is addedto the suspension obtained. The suspension is stirred (magnetic stirrer)for 2 hours and maintained static overnight in a cold room at 4° C.

Centrifugation

The suspension was centrifuged at 13,000 rpm with a Sorvall RC6 androtor SLA 15000 for 45 minutes at 4° C. The supernatant from thecentrifugation is recovered, vacuum pre-filtered on Dicalite andregenerated cellulose filters from 0.45 μm to 0.22 μm.

Ultrafiltration 300,000 Da

The product is filtered and ultrafiltered through a 300.000 da MilliporeBiomax Pellicon plane tangential flow membrane in Polyethersulfone at Piof 0.5 to 1 bar, in a cold room at 4° C.

Ultrafiltration 5,000 Da

The permeate from the 300,000 Da ultrafiltration is concentrated on a5000 da Millipore Biomax Pellicon flat tangential flow membrane inPolyethersulfone at Pi of 0.5 to 1 bar, in a cold room at 4° C. Theretentate is transferred to a 1,000 Da dialysis tube from SpectrumSpectraPor in regenerated cellulose and dialyzed against demineralizedwater and then immediately lyophilized.

Extraction from Colostrum

Bovine colostrum is preferred, in particular from Holstein (Friesian)and Guernsey cows. It has been demonstrated that these cows produce thecolostrum with the highest concentration of growth factors, immunemodulators, chemotactic factors and antibacterial/antiviral factors. Thecows are preferably calving for the second or third time. Colostrum ispreferably collected not later than the 5^(th)-6th hour after calving,preferably colostrum collected one hour after calving, because thehighest concentration of active substances is found during that period,while from the sixth hour onwards the active factors decline rapidly(only 20% are present 24 hours after calving).

The colostrum collected is tested for tuberculosis, cytotoxicity on cellcultures, mycoplasma, prions and human and bovine viruses.

The colostrum in the udder cistern is practically sterile, but oncemilked, despite all precautions, due to the high concentration of growthfactors, its bacteria count rises very rapidly during freezing andthawing, which are rather slow processes in view of the high density ofcolostrum in the first few hours.

The colostrum is then diluted with saline solution: this dilution notonly gives better filtration without clogging the filter pores, butabove all allows the release of active factors bonded to fats andcasein. The colostrum thus diluted undergoes tangential microfiltration(ceramic membranes with a cut-off between 2 and 6 μm, temperature 5/20°C., transmembrane pressure between 0.2 and 2 bars), which may berepeated, to obtain an opalescent solution free of casein, fat matrixand milk proteins. All these substances constitute over 90% of theallergic content of colostrum and cow's milk. The solution is thenpassed through membranes, or alternatively a molecular sieve with acut-off at 300,000 daltons, for further purification of the activefactors, all weighing less than 200,000 daltons.

The solution is then dialysed by ultrafiltration (cut-off 1000/2000daltons) at high pressure, and then immediately freeze-dried. The resultis a preservative-free, anallergic powder (casein and lactoalbumin areresponsible for over 95% of allergies to cow's milk) of very highsolubility, with the maximum possible concentration of active factorsand characterised by a very low bacterial count (<40 CFU).

The products obtained from serum, placenta or colostrum may be usedseparately or they may be pooled together. The products will in any casemeet the quantitative ranges specified in Tables 1-7.

The combination of the invention is advantageously used, either orallyor topically, in the treatment of conditions requiring tissue repair andregeneration, for the substitution of stem cell therapies. Inparticular, the combination of the invention, containing the samecomponents of the supernatant of stem cell cultures, are useful for theoral treatment of:

-   -   autoimmune diseases, specifically of diabetes of type I,        multiple sclerosis, arthritis, autoimmune hepatitis, ulcerative        colitis;    -   neuropathic pain;    -   gastro-intestinal diseases such as necrotising acute        enterocolitis, Chron's diseases, gastro-esophageous reflux,        enterocholitis induced by AIDS, irritable bowel syndrome,        infective colitis, spastic colitis, colitis induced by        antibiotics, hiatal hernias, short esophagus syndrome and the        like;    -   osteoporosis;

The combination of the invention is also useful for the topicaltreatment of:

-   -   different forms of alopecia;    -   corneal lesions;    -   wounds, burns, skin ulcers;    -   lesions of the oral mucosa.

For the oral treatment, the combination of the invention will beformulated with suitable carriers and excipients in suitable dosageforms such as capsules, tablets, powders, granulates, suspensions,functional food and similar forms conventionally used in thenutraceutical field.

The daily dosage of the combination will depend on the kind and severityof the condition to be treated as well as on the patient's conditions,age and sex. It will generally range from 10 to 30 g daily, in one ormore administrations, typically three to four administrations.

For the topical treatment, suitable administration forms include creams,ointments, gels, powders, lotions, mouth-washes, patches, comprisingtypically from 10 to 20% by weight of the combination of the invention.The combination of the invention obtained from colostrum, serum orplacenta, if desired may be coated for specific applications, forinstance in controlled releases forms, preferably into microspheres.

The formulations may contain other ingredients useful for specific uses.For example, for the treatment of wounds and ulcers, zinc oxide andArnica montana extract may be suitable added.

The invention will be described in more detail in the followingexperimental part, given by way of examples.

Example 1 Autoimmune disease

The effects of the preventive oral administration of PMF Ab wereevaluated on different models of autoimmune diseases such asExperimental Allergic Encephalomyelitis (EAE), type I diabetes, ulcerouscholitis induced by TNBS, hepatitis induced by ConA and arthritisinduced by adjuvant and by collagen.

Example 1a Experimental Allergic Encephalomyelitis (EAE)

EAE was induced in female SJL mice 6-7 weeks old as disclosed in J. St.Louis et al. Mice were immunised with 75 μg of proteolipidic proiteinPLP (139-151) (Genemed synthesis, San Francisco Calif.), emulsioned inCFA containing 0.6 mg/ml of Mycobacterium tuberculosis H37RA (Difco,Detroit, Mich., USA) to give a 1:1 emulsion. Each mouse received 200 μlof the emulsion sc in four sites proximal to axillar and inguinallymphonodes. The pertussis toxin (Calbiochem, Nottingham, UK) used asco-adjuvant, dissolved in water at the concentration of 2 μg/ml wasadministered ip in a volume of 100 μl at day 0 and day 2 afterimmunisation. The clinical evaluation was carried out according to thefollowing score: 0=no sign of disease, 1=flaccid tail, 2=moderateparaparesis, 3=severe paraparesis, 4=moribund, 5=death.

Two groups of 6-10 mice each were administered orally respectively PMFAb at the dose of 0.1 g/mouse and its vehicle (water) starting from day0.

PMF Ab was dissolved in water at a concentration of 0.1 mg/ml andadministered at a final volume of 0.25 ml.

Results

Effects of P.M.F. Ab on the Development of EAE Induced by PLP(Proteolipid Protein) and Pertussis Toxin.

After 42 days of treatment with P.M.F. Ab (25 micrograms), the diseasedeveloped in only 2 out of 6 mice (33.3%) compared to 9 out of 10 micein the group of mice treated with vehicle (90%). In addition, micetreated with P.M.F Ab developed a milder course of illness with a loweraverage cumulative score and a shorter duration of the disease than themice treated with the vehicle (Table 8).

TABLE 8 Effects of PMF Ab on the clinical parameters in EAE induced inSJL mice by PLP cumulative score duration Incidence Average P.M.F. Ab9.2 4.3 33.3 Vehicle 29.4 13.6 90.0 Dev. st P.M.F. Ab 15.4 7.2 Vehicle18.6 8.5 T-test P.M.F. Ab 0.042 0.040

Example 1b Type I Diabetes

Diabetes mellitus type 1 (DM type 1) is a multi factorial syndromecaused by the failure of endogenous insulin production as a result ofimmune response of auto reactive T-lymphocytes and macrophages againstpancreatic beta cells of Langerhans.

40 mg/kg of streptozotocin (STZ) were administered ip for 5 consecutivedays to male C57B16J mice 7-8 weeks old.

Two groups of 7-8 mice were treated orally from day 0 to day 21 sixtimes a week with PMF Ab at a dose of 0.2 g/mouse or with the vehicle.PMF Ab was dissolved in water at a concentration of 0.4 mg/ml andadministered at a final volume of 0.5 ml.

Mice were checked once a week measuring glycemia. Diabetes was diagnosedwhen glycemiva exceeded 11.8 mmol/L.

Results

As expected, the mice belonging to the control group treated withvehicle developed hyperglycemia 2 weeks after the last STZ injection andreached 100% incidence within 3 weeks.

In contrast, prophylactic treatment with P.M.F. Ab has completelyprotected mice from STZ-induced hyperglycemia.

Treatment with P.M.F.Ab for 21 days at a dose of 0.2 g/mouse was welltolerated.

Example 1c Ulcerative Colitis Induced by TNBS

To study the possible effects of P.M.F.Ab on this organ-specificautoimmune pathology the experimental model of IBD induced by TNBS wasused.

In the model, a single administration of TNBS is responsible for theappearance, within 4 days, of a disease with clinical immunohistologicalfeatures very similar to those found in human inflammatory bowel diseasesuch as Crohn's disease and ulcerative colitis.

Colits was induced in 20 male Balb/C mice, weighing 20-25 g, by a singleintra-cholic administration at day 0 of a solution of 4 mg oftrinitrobenzene sulfate (TNBS) in 0.1 mL of 50% ethanol.

10 animals were treated per os with PMF Ab at the dose of 0.2 g/mouseand 10 animals (controls) were treated with the corresponding vehicle(water), daily for 4 consecutive days starting from induction (days 0,1, 2 and 3).

Animals were sacrificed at day 4 and the mucosal damage (ADM) wasevaluated on a 7 cm distal colon segment. The evaluation of the score ofmacroscopic damage (SDM) was evaluated according to the followingcriteria: 0=no damage; 1=localised hyperemia and/or oedema; 2=linearulcer<than half the colon width; 3=linear ulcer>than half the colonwidth; 4=circular ulcer<1 cm; 5=circular ulcer from 1 to 2 cm;6=circular ulcer>2 cm.

Results

As expected, in the control group there was a significant reduction inbody weight between day 0 and day of sacrifice (−18%), an increase ofthe weight of the colon (0.47±0.16 g), and a marked damage in colonmucosa (average ADM=68±57 mm², Table 9).

Treatment with PMF Ab at a dose of 0.1 g/mouse showed a significantreduction in the area of necrosis and a positive trend towards thedecrease of the colon weight.

TABLE 9 Effects of PMF Ab on clinical parameters in TNBS-induced colitisin mice. Stool score Colon weight Necrosis area P.M.F. Ab 0.9 0.34219.98 Vehicle 1.8 0.469 67.61 Sham 0 0.130 0 P.M.F. Ab 1.05 0.08 12.71Vehicle 1.67 0.16 57.09 Sham 0.05 P.M.F. Ab 0.217 0.053 0.027

Example 1d Autoimmune Hepatitis

The experimental model of ConA-induced hepatitis in NMRI mice was used.

In this model, the single injection of Con A is sufficient to developimmune-mediated liver injury, evaluated by glutamate-pyruvatetransaminase (GPT) levels in plasma.

20 male albino NMRI mice, 6-7 weeks old, were inoculated iv with 20mg/kg of Con A (Sigma Chemical, St. Louis, Mo.) in sterile PBS.

10 animals were treated per os with PMF Ab at the dose of 0.2 g/mouseand 10 animals (controls) were treated with the corresponding vehicle(water), 24 hours before and 1 h our before Con A inoculation.

The animals were sacrificed 8 h after Con A injections andglutamate-pyruvate transaminase was determined in plasma.

Results

After the sacrifice, signs of acute liver damage were found in all miceof the control group injected with Con A and treated with water. Theseanimals had, in fact, marked increases in plasma GPT, reaching anaverage of 1556±869 U/I (Table 10). The treatment with PMF Ab at a doseof 0.2 g/mouse significantly reduced the GPT levels in the plasma (p.01by Student t-test).

TABLE 10 GPT values in Con A-treated mice GPT Vehicle P.M.F. Ab MEDIA1555.9 442.8 DEV. ST. 868.7 622.4 T-test 0.004

Example 1e Arthritis Induced by Collagen Type II in Mice DB/1j (CIA)

The disease can be induced in mice and in rats by intradermal injectionof type II collagen homologous or heterologous emulsified in completeFreund's adjuvant.

The effects of PMF Ab were evaluated by testing the PMF Ab at a dose of0.2 g/mouse. The animals were observed every other day for theevaluation of significant clinical parameters.

40 male DBA/j1 mice, 8-9 weeks old, were used. The disease was inducedby means of an intra-dermal inoculation of an emulsion of 100 μg ofbovine collagen type II in 100 μl emulsified in Freund's completeadjuvant (CFA) (Sigma, Milano, Italia). The animals received a secondbooster at day 21 post-immunization by means of an intradermalinoculation of 100 μg of Collagen type II in a total volume of 100 μl ofFreund's incomplete adjuvant.

Four groups of 10 animal each were respectively treated per os dailywith PMF Ab (0.2 g/mouse), with the corresponding vehicle (sterile PBS)and with Dexametasone (0.3 mg/kg), starting from induction day until day30 post-induction. A further group of 10 healthy mice was added (Sham).The clinical index of arthritis was evaluated by scoring each animal'spaw (thickness, swelling/oedema, involvement of one, two or more joints)

Results

Animals of the control group developed arthritis-associated clinicalsigns within 29 days after induction, showing a gradual increase both inthe clinical score of disease and in paw thickness, reaching a maximumvalue at day 40. No difference was found between the increase in bodyweight in the treated group and in the control group.

PMF Ab at a dose of 0.2 g/mouse significantly reduced the clinical scoreof disease (p<0.05 vs. vehicle by t-test) from day 30 to day 33post-induction, with a positive trend from day 34 until the end of thestudy.

Similar results were obtained in Lewis rats, in a model ofadjuvant-induced arthritis.

Example 2 Neuropatic Pain Example 2a Animal Experiments

The model of chronic constriction injury (CCI, Bennett and Xie, 1988)was used because it produces a robust Wallerian degeneration andinflammation. In addition, since some fibers survive the injury, thereremains the possibility to conduct behavioral tests to assess the painsymptoms.

The neuropathy was induced in C57BL/6J male mice of nine weeks, weighing20-25 g. Under barbiturate anesthesia, with the aid of a dissectingmicroscope, the sciatic nerve was exposed at the middle of the right pawand before the trifurcation and three loose ligatures were made aroundit, taking care to preserve the epineural circulation.

False-operated animals (exposure of the nerve without ligation) servedas a control.

The thermal hyperalgesia was evaluated according to the procedure ofHargreaves modified for the rat, using a tool Plantar test. In short,the mice are placed in small cages of Plexiglas and a radiant heatsource of constant intensity is directed towards the central part of thehind paw. The time (seconds) from the activation of source to thewithdrawal of the paw was recorded.

PMF Ab was administered orally at a dose of 0.4 g/mouse every day fromthe time of injury for three weeks.

Results

The results are reported in the following Table 11

DAYS 14 21 28 LATENCY Controls 18 20 18 THRESHOLDS Neuropathy 12 14 18(DAYS) Treatment 8 7 9 with PMF Ab

Treatment with PMF Ab led to an increase in the thresholds of analgesiathat were significantly higher than that of neuropathic animals treatedwith diluent already from day 21 to reach the same levels of normalanimals at day 28 of treatment.

Example 2b Clinical Experiments in Humans

Six subjects 4 males and 2 females, suffering from post-herpetic painafter herpes from two to three years, were treated every day for thirtydays with PMF Ab orally (10 g/daily).

Pain was assessed subjectively using the VAS (Visual Analogue Scale) andobjectively, using a test of hyperalgesia represented by stimulationwith von Frey filaments of the areas affected by the disease and itssurrounding areas.

The study was “open”, assessing the levels of pain and hyperalgesia frombaseline (start of treatment).

Subjects treated with PMF Ab experienced an improvement of thesubjective pain sensation, with a variation in VAS after 15 days oftreatment from 6.0 to 2.0. The latter value was maintained until the endof treatment (30 days). Stimulation with von Frey filament (sequence ofpressures from 0.05 to 140 g) resulted in significantly different curvesof VAS/applied force, indicating a progressive improvement ofhyperalgesia from the twentieth day of treatment until the end.

Example 3 Treatment of Anorexia

Twenty female patients aged between sixteen and thirty years, sufferingfrom anorexia nervosa with weight loss between 15 and 30% of what isconsidered normal for the age and the physical structure, were treateddaily with 40 g of PMF Abby the oral route. It is interesting to notethat all patients, despite the serious nutritional problems, agreed totake the product since they were reassured that the product itself doesnot increase body fat but only the muscular mass, positively influencingcardiocascular, respiratoruiy and neurological parameters.

After three months of adjuvant therapy, 50% had recovered more than 30%of body weight with a significant improvement in physical and mentalabilities. The blood chemistry parameters were normalized.

Surprisingly, 25% of these patients even resumed to eat normally withrestitutio ad integrum of body mass. The remaining 25% did not respond.

Example 4 Osteoporosis

The effect of P.M.F. Ab was evaluated in vitro and in vivo assays forproliferation and differentiation of osteogenic mesenchymal stem cells,progenitors of bone, and osteoblasts.

Example 4a In Vitro Tests

Proliferation

The effects of P.M.F. Ab on cell proliferation were evaluated usinghuman osteoblast (Saos-2 and MG-63) cells and human mesenchymal stemcells, as a model osteoblast precursor (human Adipose tissue-derivedStem Cells, hASC).

The ASC were isolated (Zuk P A et al., 2001) from 6 donor volunteers andkept in control medium (DMEM supplemented with sodium pyruvate, 10% FCS,100 U/ml penicillin, 100 mg/ml streptomycin and 250 ng/ml amphotericinB). Osteoblasts line Saos-2 (ATCC number: HTB-85) and MG-63 (ATCCnumber: CRL-1427) were purchased from ATCC. Saos-2 and MG-63 weremaintained respectively in McCoy′5A (Gibco, Life Technologies) with 15%FBS, and in DMEM with 10% FCS.

The cells were seeded in 96-well plates and subjected to MTT test ondays 1, 3, 5 and 7 and were maintained in a humidified atmosphere of 5%CO2 in air at 37° C. PMF Ab shows a potent dose-dependent proliferativeeffect on all the lines studied, ceiling at a concentration of 5 mg/ml.

Example 4b In Vivo Tests in Ovariectomized Female Rats

The effects of PMF Ab on bone mass was investigated in an animal modelof osteopenia (surgical Oophorectomy) in mature rat comparable withhuman postmenopausal osteoporosis.

Sprague-Dawley rats 5 months old subjected to surgical bilateraloophorectomy were used. The effects of PMF Ab on bone mass were assessedby measuring both planar and volumetric femoral bone mineral density(BMD) (distal metaphysis and medial diaphysis) by means of computerizedbone mineral density (DXA) and bone computed tomography (pQCT). mRNAsfor interleukin-8, the RANKL factor and osteprotegine peptide wereassessed as biochemical markers of bone turnover. The rats were treatedfor 60 days from the time of ovariectomy with PMF Ab orally (2-4-8 g/kg)for 5 days/week. Both BMD and biochemical parameters of bone turnoverwere assessed both before (T0), during (T30) and at the end of treatment(T60).

The treatment induced a dose dependent-recovery from osteopenia and anormalisation of the related biochemical parameters.

Example 5 Treatment of Acute Necrotising Colitis (NEC)

A model of NEC in pigs, identical to macroscopic and microscopicpathological effects in the human, was used.

1. Comparison of Subjects Fed with Milk Formula+PMF Ab and Subjects OnlyFed with Milk Formula

The subjects fed with formula milk plus 20 g/die of PMF Ab have aregular growth comparable to that of the control group maintained undersow. The piglets fed from birth with only milk formula, after the firstday of regular growth, exhibit from the second day prostration,locomotor ataxia, interruption of spontaneous alimentation,regurgitation and diarrhea. After a quick weight loss within a further24-48 hours, the animals died. Histopathological examination of thevarious sections of the large intestine taken post mortem allowed thediagnosis of lethal acute necrotizing enterocolitis, confirmed byelectron microscopy (FIGS. 1 a and 1 b).

2. Comparison of Groups Fed with Increasing Doses of PMF Ab

Subjects fed with formula milk+20 g/day of PMF Ab: regular growth,entirely comparable to that of the control group maintained under sow.

Subjects fed with milk formula+1 g/day of PMF Ab: the subjects slimquickly and within a further 24-48 hours, the entire group die.

Group of subjects fed with milk formula+5 g/day of PMF Ab: a conditionof real cachexia occurs and within a few days the death of the entiregroup. The histopathological examination of several sections of thelarge intestine taken from groups of subjects fed respectively with 1g/day and 5 g/day of PMF Ab, allows the diagnosis, also in this case, ofa lethal acute necrotizing enterocolitis.

Group of subjects fed with milk formula+10 g/day of PMF Ab: diarrheaoccurs in all the subjects. On the 13th-14th day, the pathologicalmanifestations worsen suddenly and the animals die within a few hours ofacute necrotizing colitis.

Group of subjects fed with milk formula+15 g/day of PMF Ab: regulargrowth, with no observed pathological manifestation of any kind, but theperformance of growth are slightly lower than those from the group ofsubjects fed with milk formula+20 g/day of PMF Ab.

Group of subjects fed with formula milk+20 g/day of PMF Ab (maintaineduntil day 15): regular growth, entirely comparable to that of thecontrol group maintained under sow.

3. Comparison of Subjects Fed with Milk Formula+PMF Ab and Subjects Fedwith Only PMF Ab+Sugar Solution Ad Libitum

Piglets fed ad libitum with a sugar solution+20 g/day of PMF Ab, withoutthe addition of milk formula, do not have any kind of disease but loseweight steadily, a sign of an insufficient supply of nutrients providedby the sugar solution in place of the milk formula. These individualseventually die, but the colon, at the histopathological examination, issurprisingly absolutely normal without any signs of acute necrotizingenterocolitis.

Example 6 Topical Treatment of Skin Ulcers

Ten patients (6 men—4 women) affected by diabetic ulcers of legs, knownto be particularly difficult to treat since connected to a systemicdisease, were treated twice a day with topical application of 5% aqueoussolution of PMF Ab. The complete recovery occurred after 4-6 weeks inseven patients with diabetic ulcers having a surface ranging from 2.5 to24.5 cm; in three cases, the initial lesion improved to an extent from60% to 85%.

Example 7 Treatment of Oral Lesions

The effectiveness of PMF Ab, either in free form or incorporated inmicrospheres, was tested in a clinical trial in which 50 patients (malesaged between 18 and 43 years, mean age 28.73), free of pathologicalconditions other than recurrent oral stomatitis were enrolled (No. 25)in Group I of the study (topical application of 5% aqueous solution ofPMF Ab, 3 times a day) and in control Group II (rinse with benzidaminehydrochloride 3 times a day for 2 minutes).

The size of the ulcers, pain (with VAS score) and the degree ofsatisfaction of the treatment have been assessed. Topical application ofPMF Ab resulted in complete resolution of ulcers in 8 patients within2-4 days, 4-7 days in 10 patients, within 7-10 days in the remaining 7patients in Group I. In the control group II, there was complete healingof aphthous ulcers in 3 patients within 2-4 days, 4-7 days in 9patients, within 7-10 days in the remaining 10 patients, with 3 patientsstill suffering from the disease. The average size of ulcers in the twogroups was significantly lower from the fourth day for the study group(I) compared to the control group (II).

Example 8 Therapy of Corneal Lesions in Dogs

The research was performed on 5 dogs that had photophobia, epiphora,blepharospasm. The dogs had corneal lesions due to generic type trauma(injury by foreign bodies, cat scratch, etc.).

Eye drops containing 5% PMF Ab were administered twice daily byconjunctival instillation for a period of 8-10 days.

Results

Two superficial ulcers, one recurrent indolent ulcer and two deep ulcerswere detected in the five dogs under test.

Healing of corneal injury occurred in all subjects. Healing means thecomplete healing of the lesion and the negativisation of the fluoresceintest, as well as the disappearance of symptoms reported at clinicalexamination (blepharospasm, photophobia, epiphora). In all cases it wasalso possible to preserve the animals' sight and no permanentcicatritial leukoma was observed notwithstanding that no other treatment(e.g. local corticosteroids) or any other therapeutic agent had beenused.

The mean recovery was 6 days. It should be noted that, in addition tohealing of the ulcer, probably due to an effect similar to that oflimbial stem cells, PMF Ab has also acted as an antibacterial agent,preventing the development of secondary infections, and asanti-inflammatory agent, leading to a complete wound healing withoutresidual scars.

Example 9 Treatment of Alopecia

Alopecia can be effectively prevented and treated by PMF Ab, preferablyby applying in succession a first topical composition which acts on thehair bulb in the catagen phase and a second topical composition thatstimulates the anagen phase of hair re-growth.

The first topical formulation comprises as active ingredients oil resincapsicum, Vitamin PP and caffeine in addition to conventionalexcipients. The second composition, to be applied on the scalp 15 to 30minutes after application of the first composition, comprises PMF Abpartially in free form and partially encapsulated in microspheres andother ingredients selected from sericin, Aloe vera extract, caffeine,melatonin and panthenol. Examples of suitable formulations are reportedbelow:

1 Pre-Treatment

Oil resin capsicum 0.05%

Vitamin PP 0.20%

Caffeine 0.01%

excipients qs

2 Treatment

P.M.F. Ab 10.00%

P.M.F. Ab micro encapsulated 2.5%

Sericin 1.00%

Aloe 1.00%

Panthenol 0.20%

Melatonin 0.005%

Caffeine 0.01%

excipients qs

The formulations were tested clinically on 30 cases of recurrent hairloss (telogen), especially in spring and autumn. The hair loss has beenprevented in 88% of males and 75% females.

In 20 patients subjected to chemotherapy (women with breast cancer),only 12% of patients lost their hair, 20% hair have thinned, but did notfall, in all cases with no adverse effect.

The formulations were also tested in 10 patients with sharp loss ofhair, 10 patients with chronic loss of hair, 5 patients with alopeciaareata, 40 patients with androgenetic alopecia and 7 patients withcicatricial alopecia.

In sharp loss of hair, the response to therapy of patients, 8 women and2 men, was variable.

After two months of application of the product, once a day, a clearreduction in hair loss was detected in 8 patients (7 women—1 man) with amodest recovery in only one case (male) in the third month of therapywhile in remaining two cases (respectively a man and a woman), thesituation was unchanged.

In chronic hair loss, of the 10 cases treated (9 women and 1 man) 8patients had a decrease after two months of therapy. Two patients didnot respond to therapy.

In alopecia areata all treated subjects (5 patients, 3 women and 2 men)had little or no response after two months of therapy.

40 subjects (30 men and 10 women) affected by androgenetic alopecia weretreated. After two months of therapy, a reduction in hair loss andimprovement in the appearance of hair, quantifiable with a largerdiameter of the barrel, higher volume and higher gloss of the hair in 30of the cases treated.

In the other 10 cases, the clinical condition has remained unchanged.

In 7 cases of cicatricial alopecia (4 women and 3 men), in which therewas also an inflammatory reaction of the skin with a strong sense ofitching, the response was surprising after one month of therapy.

There has been a decline and even disappearance of itching, attenuationof the citaneous irritative form and a stabilization of the alopecia.

1. A combination of: Cytokines: from about 50 to about 300 pg/mg, Growth factors: from about 650 to about 1900 pg/mg, Chemotactic factors: from about 2 to 20 pg/mg; Stem cell stimulating factors: from about 100 to 1200 pg/mg, Antibacterial/antiviral factors: from about 30 to 80 μg/mg, Complement C3a/C4a proteins: from about 1 to 5 pg/mg, and Immunoglobulins: from about 0.3 to 0.9 mg/mg.
 2. The combination according to claim 1 obtainable by extraction of colostrum.
 3. The combination according to claim 1 obtainable by extraction of placenta.
 4. The combination according to claim 1 obtainable by extraction of serum of pre-partum serum.
 5. The combination according to claim 1 for use in the treatment of conditions requiring tissue repair and regeneration and for the substitution of stem cell therapies/transplants.
 6. The combination according to claim 5 wherein the conditions are selected from the group consisting of autoimmune diseases, neuropatic pain, osteoporosis, wounds, burns, skin ulcers, oral lesions, necrotising acute colitis, Chron's diseases, gastro-esophageous reflux, enterocholitis induced by AIDS, irritable bowel syndrome, infective colitis, spastic colitis, colitis induced by antibiotics, hiatal hernias, and short esophagus syndrome.
 7. Pharmaceutical compositions comprising the combination according to claim 1 as the active ingredients in admixture with suitable carriers and/or excipients.
 8. Pharmaceutical compositions according to claim 7 for oral administration.
 9. Pharmaceutical compositions according to claim 7 for topical administration.
 10. A combination of: Cytokines: from 47.81 to 264.56 pg/mg, Growth factors: from 670.80 to 1869.40 pg/mg, Chemotactic factors: from about 2 to 20 pg/mg; Stem cell stimulating factors: from about 136 to 1120 pg/mg, Antibacterial/antiviral factors: from about 21.30 to 71.50 μg/mg, Complement C3a/C4a proteins: from about 1.10 to 2.70 pg/mg, and Immunoglobulins: from about 0.35 to 0.85 mg/mg. 